4529- Coding Specialist

Innovaccer Analytics; United States; Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Paid time off

Parental leave

Rewards program

Insurance coverage

Job summary

Innovaccer Inc. is seeking a Coding Specialist I to independently review, analyze, and resolve front-end claims, ensuring accurate coding before transmission.

You will apply CPT/ICD-10-CM guidelines, mentor with the coding team, and uphold HIPAA standards. You will review records, ensure medical necessity, and maintain high coding accuracy while collaborating with revenue cycle partners to reduce rejections and improve clean claim rates.

Qualifications

• Current AAPC or AHIMA certification for at least 3 years.
• Strong knowledge of CPT, ICD-10-CM, medical terminology, and Medicare guidelines.
• Proficient in English grammar and professional documentation.
• Ability to analyze data and resolve coding issues.
• Ability to interpret policies, laws, and medical documentation.
• Independent judgment in coding and claim resolution.
• Excellent written and verbal communication; collaborate with physicians and staff.
• HIPAA compliance and confidentiality.
• Experience in a medical billing environment with strict HIPAA adherence.

Responsibilities

• Reviewing front-end claims and resolving holds to ensure timely submission.
• Reviewing medical records to determine correct codes for services and diagnoses.
• Escalating coding questions to the Coding Team Lead for guidance.
• Maintaining coding accuracy and compliance with guidelines.
• Participating in meetings and mentoring with the Coding Team Lead.
• Maintaining CEU requirements and continuing education.

Skills

CPT

ICD-10-CM

Medical terminology

Anatomy & physiology

Medicare guidelines

English grammar

Microsoft Office

Data analysis

Communication

HIPAA compliance

Education

AAPC or AHIMA certification

Tools

Microsoft Office Suite

Job description

About the Role

The Coding Specialist I is responsible for independently reviewing, analyzing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. The Coding Specialist I works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment.

A Day in the Life

• Averages 10 front-end holds per hour
• Maintains a minimum of 90% coding accuracy.
• Assigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environment.
• Reviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnoses.
• Ensures all diagnosis codes meet local and national medical necessity guidelines.
• Utilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned services.
• Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality.
• Maintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practices.
• Independently reviews and resolves all assigned front-end claim holds.
• Actively participates in department meetings, one‑on‑one meetings, and mentorship meetings with the assigned Coding Team Lead.
• Escalates identified client trends to the assigned Coding Team Lead.
• Escalates all coding‑related questions to the assigned Coding Team Lead for guidance and clarification.
• Maintains and completes all CEU requirements.
• Performs other duties or tasks as assigned.

What You Need

• Must hold a current AAPC or AHIMA Certification for a minimum of 3 years.
• Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare reimbursement guidelines.
• Familiarity with proper English grammar, usage, and professional documentation standards.
• Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issues.
• Ability to read, interpret, and apply policies, procedures, laws, and regulations.
• Ability to accurately read and interpret medical documentation, clinical terminology, and documented procedures.
• Demonstrated ability to exercise independent judgment in coding and claim resolution.
• Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staff.
• Strong commitment to maintaining confidentiality and safeguarding protected health information.
• Prior experience working in a medical billing environment with strict adherence to HIPAA compliance requirements.
• Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams).
• Minimum of 3+ years of professional coding experience.

We offer competitive benefits to set you up for success in and outside of work.

Here’s What We Offer

• Generous Paid Time Off: Recharge and relax with 20 days of fixed time off per year, in addition to company holidays—because we believe work‑life balance fuels performance.
• Best-in-Class Parental Leave: Spend quality time with your growing family. We offer one of the industry’s most generous parental leave policies to support you during life’s most important moments.
• Recognition & Rewards: We celebrate wins—big and small. Get rewarded with monetary incentives and company‑wide recognition for your impact and dedication. Your hard work won’t go unnoticed.
• Comprehensive Insurance Coverage: Stay covered with medical, dental, and vision insurance, plus 100% company‑paid short‑and‑long‑term disability and basic life insurance. Optional perks include discounted legal aid and pet insurance.

Innovaccer Inc. is an equal opportunity employer. We celebrate diversity and are committed to fostering an inclusive workplace where all employees feel valued and empowered regardless of any characteristic protected by federal, state or local law including, without limitation, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, medical condition, disability, age, marital status, or veteran status. Innovaccer Inc. participates in the E-Verify program to confirm employment eligibility of all newly hired employees based out of the U.S. and employed by Innovaccer Inc.

For any additional information, please visit the below websites:

E-Verify

Right to Work (English)

Right to Work (Spanish)